Utility of contrast echocardiography in the diagnosis of aortic dissection.

Determination of ascending aortic involvement in aortic dissection has significant implications in prognosis, immediate surgical referral, and surgical approach. We report 2 cases of the use of an echo contrast agent in enhancing the diagnostic capability of transesophageal echocardiography in suspected ascending aortic dissection. Contrast echocardiography eliminated the linear artifacts often confused with true dissection flaps and allowed easy identification of the presence of true and false lumina.

Mercy Healthcare's CARE 2000: an evolution in progress.

In a learning environment of shared governance, continuous quality improvement, and redesign principle application, disciplines of Mercy Healthcare San Diego produced their patient care delivery redesign model, Creative Actions Reflecting Excellence. Nurses, pharmacists, medical technologists, respiratory care practitioners, physicians, educators, managers, and many other professional and technical partners converted change and transition into opportunities. As disciplines understood and appreciated each other's unique and shared contributions, quality of care, stakeholder satisfaction, and process efficiencies increased.